Survey of Adult Flexible Bronchoscopy Practice in Cairo

Data regarding the standards of bronchoscopic practice in Cairo hospitals, where the main bulk of the procedures in Egypt takes place, are lacking and have not been studied. A questionnaire-based survey was conducted aiming to assess the present status of performing flexible bronchoscopy (FB) and the extent of variations in chest physicians practice. All bronchoscopists performing FB were identified. A questionnaire consisting of 50 questions covering different aspects of bronchoscopy practice was distributed. Seventy-five bronchoscopists out of 87 (86%) returned the questionnaire and they had performed a total of 5994 bronchoscopies in the preceding year. The majority of practice is limited only to around 55% of bronchoscopists. The responders sometimes (20%) or never (3%) take proper precautions while performing FB in suspected airborne infections. Only 15% of bronchoscopists obtained a signed patient consent before bronchoscopy. Fifty-three (75%) of bronchoscopists gave benzodiazepine sedation and only 30 (42%) record availability of sedative antagonists. Sixty-six (88%) responders prescribed atropine. All bronchoscopies were performed under topical lidocaine. Seventy-six percent of physicians monitored oximetry and 15% never monitored oximetry during the procedures. Marked variance was noted in sampling routines of suspected tumors. Only 21 (28%) and 47 (63%) of responders had performed transbronchial needle aspiration or lung biopsy over the preceding year, respectively. The mortality rate of FB was 0.01% with a 3% incidence of complications. We concluded from the presented data that bronchoscopic practice in Cairo is not standardized, and there is a need for national database, guidelines, and training programs for bronchoscopy practice.